The aim of this study was to investigate the oncological outcomes in patients affected by oral carcinoma treated with radical compartmental surgery followed by microvascular flap reconstruction. (27.7%) patients died, only 3 of which for other causes. The 5-year DSS rate was 67.8% (S.E. 4.9%). In univariate Kaplan-Meier analysis and in multivariate Cox regression model, seven variables were found to have a significant relationship with DSS: T (p = 0.026) and N (p = 0.0001) status, clinical stage (according to the UICC TNM Sixth Edition) (p = 0.007), margins of resection (p = 0.001), extracapsular spread (p = 0.005), recurrence of disease (p = 0.00002) and treatment modality (evaluated as surgery alone or surgery + RT/CHT) (p = 0.004). Our results confirmed findings already reported in the literature, and allowed us to conclude that compartmental surgery combined with free flap reconstruction can increase survival in oral cancer patients. value <0.05 was considered statistically significant. Results There were 46 (35.4%) women and 84 (64.6%) men in the sample with a mean age of 58.5 years 12.04 (range 26 to 83 Aliskiren years). On a total 130 patients, 119 received primary surgery in our department; 13 received salvage surgery for persistence/recurrence of disease; 11 underwent primary surgery in different hospitals and were referred to us for treatment of recurrence with reconstructive surgery. As shown in Table I, 58 patients (44.6%) received an ALT flap, 28 (21.5%) a fibula flap, 18 (13.9%) a FFR flap, 14 (10.8%) a DIEP flap, 6 (4.6%) a TRAM flap and 1 (0.8%) a VRAM flap reconstruction. Five patients (3.8%) underwent reconstruction with a chimeric flap, defined as a combined composite flap used in special cases in which we had the need to reconstruct, in addition to a bone defect, an extensive cutaneous or mucosal defect. At the end of the follow-up period, on June 2013, (average 33.4; range 2 to 205 months) 36 patients had died, 33 for the disease and Aliskiren 3 for other causes. We observed a 5-12 months DSS of 67.8% ( 4.9% Rabbit polyclonal to PPP6C SE) (Fig. 1). Univariate Kaplan-Meier analysis exposed statistically significant associations between DSS and T (p = 0.026) and N (p = 0.0001) status, clinical stage (p = 0.007), margins of resection (p = 0.001), extracapsular spread (p = 0.005), recurrence of disease (p Aliskiren = 0.00002) and treatment modality (p = 0.004). Results are demonstrated in Table II. Kaplan- Meier survival curves by different variables are demonstrated in Number 2. Fig. 1. Cumulative disease-specific survival. Fig. 2. Kaplan-Meier survival curves by: A, Tumour size (p = 0.026); B, N status (p = < 0.0005); C, Clinical Stage (p = 0.007); D, Margins of resection (p = 0.001); E, Extracapsular spread (p = 0.005); F, Recurrence (p = < 0.0005); G, Treatment ... Table II. Kaplan-Meier analysis: relationship between variables and survival. On multivariate Cox regression analysis, the same variables showed a significant relationship with DSS, and in particular N stage (HR 2.2; p = 0.0001), margins of resection (HR 2; p = 0.0001) and recurrence of disease (HR 5.3; p = 0.00001). Results are summarised in Table III. Table III. Cox regression analysis. Flap complications Nine individuals experienced major complications after surgery (9/130; 6.9%). Five individuals experienced total flap failure for venous thrombosis (5/130; 3.8%); one of these was preserved after vascular re-exploration, and the additional four required a second flap. Three individuals had exposure of osteoplastic plates and one patient experienced salivary fistula. The majority of these complications occurred when a fibula flap was used for reconstruction (6 instances) and 2 of 8 complications occurred when using additional.